Over the past decade, concerns about delays in the VA system have spurred legislation to make health care outside the VA system more accessible for veterans.1 As George et al1 remind us, however, better access to health care does not necessarily result in improved outcomes. By showing that veterans have lower 30-day postoperative mortality in VA hospitals compared with private sector hospitals, they demonstrate the important distinction between quality of care and timeliness of access. George et al should be congratulated for bringing this important policy issue to light, and for reminding us that improving patient outcomes requires attention not only to access to care, but also to quality of care.